Provider Demographics
NPI:1013266246
Name:DAVID SALAH DDS PC
Entity Type:Organization
Organization Name:DAVID SALAH DDS PC
Other - Org Name:PROGRESSIVE DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER ,PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-349-7560
Mailing Address - Street 1:21580 NOVI RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-5600
Mailing Address - Country:US
Mailing Address - Phone:248-349-7560
Mailing Address - Fax:
Practice Address - Street 1:21580 NOVI RD
Practice Address - Street 2:SUITE 100
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-5600
Practice Address - Country:US
Practice Address - Phone:248-349-7560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-04
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010165041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty